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Why You Feel Nauseous – Causes, Treatments, When to Seek Help

We all know the feeling. A sour stomach, sometimes mixed in with some lightheadedness and dizziness, and that feeling that you might puke your guts out at any second. Not only is it not pleasant, but feeling nauseous can be embarrassing. Not to mention disturbing if it’s a regular occurrence.

According to Christine Lee, MD, a gastroenterologist at the Cleveland Clinic, there are a number of reasons you may feel like you’re “always” nauseous. The first thing you should determine is if it’s mild and temporary—it comes and goes without intensity and needing any intervention. “If you find yourself frequently experiencing nausea that doesn’t resolve itself quickly and persists, you should get it checked out to get to the root of the problem,” she says. “Symptoms such as vomiting blood, inability to keep anything, including water and saliva, down, high fevers, intense pain and shortness of breath are definitely causes for concern. ” Meaning, get to a doctor now.

But if you’re not vomiting and you frequently feel nauseous, discover some potential causes and when you should seek professional help.

1) You started taking a new medication

Nausea can sometimes be a side effect of non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen, so consult your doctor if this is the case and to see if switching to another painkiller or anti-inflammatory might be a safer bet for you.

2) You’ve had anesthesia or chemotherapy

If you’ve just had surgery and are loaded up on pain medications or narcotics, or you’ve been receiving chemotherapy as cancer treatment, nausea is a common side effect you should be aware of, Dr. Lee says. Don’t hesitate to talk to your medical team about what to expect.

“Nausea and vomiting is very common when you wake up after having received anesthesia, so your provider should ask if you have this history and provide you with anti-nausea medications beforehand, if necessary,” she says.

3) You have a balance disorder, or you’ve been sick

Balance disorders such as vertigo, labyrinthitis, and vestibular neuronitis are commonly accompanied by nausea, Dr. Lee says. In this case, getting to the root of the problem can help you manage your nausea.

You may also experience feelings of nausea after a cold or other upper respiratory tract infection. Even a lack of sleep could bring it on.

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4) You have motion sickness

“If you experience motion sickness where repeated motions such as with riding on a boat or experiencing turbulence on a flight, or even when moving on a rollercoaster or a car ride, you should still talk to your doctor,” Dr. Lee says.

Persistent nausea could be related to inflammation; it’s worth seeing a gastroenterologist to see if this is the case. If you’re otherwise fine and experiencing common motion sickness, “you might find ensuring you’re well-hydrated can help you get to the root of the problem and possibly avoid it in the future.

5) You have underlying medical conditions

No surprise here that nausea can be tied to a digestive or gastrointestinal disorder, such as gastroparesis, gastritis, PUD (peptic ulcer disease), GERD (gastrosophageal reflux disease), inflammatory diseases, pancreatic disorders (such as pancreatitis or gallstones), intestinal obstruction (such as constipation, bowel obstruction or appendicitis), Dr. Lee says.

Similarly, other more rare but serious causes can be vascular disorders such as heart artery blockages blood clots, or a brain-related issue such as meningitis or a hemorrhage.

Finally, hyper- or hypoglycemia (too high or too low blood sugar), DKA (diabetic ketoacidosis), dehydration, and heat stroke can also be contributing causes of nausea. If you are really always nauseous, meaning it’s frequent and recurring, you want to see a doctor to rule out these serious conditions.

6) You’re extremely hungry

It may seem counterintuitive that being hungry could bring you the point of wanting to puke, but it’s fairly common, as allowing yourself to get extremely hungry can lead your body to feel overwhelmed by the buildup of stomach acid, Dr. Lee says.

In an effort to constantly be “on” for work, it can be easier than you think to skip breakfast, lunch or a snack. Similarly, not properly fueling for a workout can make you have to stop exercising because of feelings of nausea, dizziness or lightheadedness. Don’t skimp on a pre-workout snack, especially if you’re going to get your sweat on later in the day.

7) You have symptoms of anxiety

Acute stress situations and the feelings of nervousness, stress, and fear you have can bring on butterflies in your stomach or even nausea, Dr. Lee says. It would be great if you could control the stress, but that’s easier to say than to do. To take down the nausea, make sure you’re properly hydrated and fed. Keeping caffeine to a minimum can also help avoid feeling nausea.

The bottom line on frequent nausea

Because the range of reasons you feel nauseous all the time is so wide, it’s important to focus not just on the symptoms, but to know all of the possibilities.

If you have unexplained nausea—it’s not because you’re hungry, tired, or carsick, for instance—and it’s frequent, you should get it checked out by a doctor. “The earlier the diagnosis, the better the prognosis and outcome, so the message we want to send is to seek medical attention to make sure it’s not anything serious,” Dr. Lee says.

Emilia Benton
Emilia Benton is a Houston-based freelance writer and editor.

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4 Ways to Cure Nausea

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Board Certified Gastroenterologist

This article was co-authored by Peter Gardner, MD. Peter W. Gardner, MD is a board certified physician who has practiced Gastroenterology and Hepatology for over 30 years. He specializes in diseases of the digestive system and liver. Dr. Gardner earned his Bachelor’s degree from the University of North Carolina and attended Georgetown Medical School. He completed his residency in Internal Medicine and then his fellowship in Gastroenterology at the University of Connecticut. He is a previous Chief of Gastroenterology at Stamford Hospital and remains on the staff. He is also on the staff of Greenwich Hospital and New York (Columbia) Presbyterian Hospital. Dr. Gardner is an Approved Consultant in Internal Medicine and Gastroenterology with the American Board of Internal Medicine. This article has been viewed 6,116,159 times.

Co-authors: 206

Updated: June 8, 2021

Views: 6,116,159

Medical Disclaimer

The content of this article is not intended to be a substitute for professional medical advice, examination, diagnosis, or treatment. You should always contact your doctor or other qualified healthcare professional before starting, changing, or stopping any kind of health treatment.

Article SummaryX

To cure nausea, try lying down and applying a cool, damp cloth to your forehead, which can temporarily relieve an upset stomach. You can also cure nausea by sipping on ginger ale or tea since ginger has nausea-relieving properties. Peppermint tea or candies can also have a similar effect. If home remedies aren’t cutting it, try taking an over-the-counter anti-nausea medication, like Pepto-Bismol or Mylanta. To learn how to use relaxation techniques to cope with nausea, keep reading!

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Motion Sickness | Michigan Medicine

Topic Overview

What is motion sickness?

If you’ve ever been sick to your stomach on a rocking boat or a bumpy airplane ride, you know the discomfort of motion sickness. It doesn’t cause long-term problems, but it can make your life miserable, especially if you travel a lot.

Children from 5 to 12 years old, women, and older adults get motion sickness more than others do. It’s rare in children younger than 2.

Motion sickness is sometimes called airsickness, seasickness, or carsickness.

What are the symptoms?

Motion sickness can cause:

  • A general feeling that you’re ill.
  • Nausea.
  • Vomiting.
  • Headache.
  • Sweating.

Symptoms will usually go away soon after the motion stops.

What causes motion sickness?

You get motion sickness when one part of your balance-sensing system (your inner ear, eyes, and sensory nerves) senses that your body is moving, but the other parts don’t. For example, if you are in the cabin of a moving ship, your inner ear may sense the motion of waves, but your eyes don’t see any movement. This conflict between the senses causes motion sickness.

You may feel sick from the motion of cars, airplanes, trains, amusement park rides, or boats or ships. You could also get sick from video games, flight simulators, or looking through a microscope. In these cases, your eyes see motion, but your body doesn’t sense it.

How is it treated?

You can take medicine to prevent or reduce nausea and vomiting. These include:

  • Scopolamine, which comes as a patch you put behind your ear.
  • Medicines called antiemetics, which reduce nausea. Examples are ondansetron (Zofran) and prochlorperazine (Compazine).
  • Certain antihistamines, such as dimenhydrinate (Dramamine) and meclizine (Antivert, Bonine). These may make you drowsy.

Some of these medicines require a prescription. Most work best if you take them before you travel.

These tips may help you feel better when you have motion sickness:

  • Eat a few dry soda crackers.
  • Sip on clear, fizzy drinks such as ginger ale.
  • Get some fresh air.
  • Lie down, or at least keep your head still.

How can you avoid motion sickness?

It’s best to try to prevent motion sickness, because symptoms are hard to stop after they start. After symptoms start, you may feel better only after the motion stops.

These general tips may help you avoid motion sickness:

  • Move your head as little as possible.
  • Don’t drink alcohol or eat a heavy meal before you travel.
  • Don’t eat or drink during short trips.
  • Try to avoid strong odors and spicy foods.

In a car

To avoid motion sickness when you travel by car:

  • Sit in the front seat.
  • Don’t read or watch TV or videos.

In a plane

When you travel by airplane:

  • Ask for a seat near the wings.
  • Eat small meals of foods that are easy to digest before and during a long flight. This may help reduce nausea and vomiting.

On a ship or boat

When you travel by ship or boat:

  • Book a cabin near the middle of a ship and near the waterline. Sit in the middle of a boat.
  • Try to get fresh air.
  • Look at a fixed point on the horizon.

Many people try other methods of preventing motion sickness, such as taking powdered ginger capsules or wearing acupressure wristbands. There isn’t much evidence that they help, but it’s safe to try them.

Nausea After Workout – 5 Reasons Running Can Make You Get Sick

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Unless you have ironclad guts, there’s a good chance you’ve thrown up thanks to running or become nauseous after a workout. Upchucking is an unpleasant occurrence that doesn’t discriminate between weekend warrior or seasoned pro—just take the end of the 2020 Marathon Project race in Arizona. Finishing second overall, Noah Droddy ran a huge personal best of 2:09:09, putting him ninth all-time among American runners. But as he told the Citius Mag podcast following his huge race, he was battling nausea the final few miles, and it’s a common occurrence when he races. “To be honest, I’ve thrown up after every marathon I’ve done. Stop. Throw up. No pause,” he said on the podcast.

So no, feeling some nauseous won’t necessarily sidetrack your entire effort, but knowing its possible causes is essential if you want to avoid regurgitating after (or during) a tough run. If you’ve ever found yourself draped over a trashcan after picking up your race medal, here are some possible reasons for your gut’s dissatisfaction—and the ways you can try combating it.

Want to run smart and healthy this year? Sign up for Runner’s World+ for the best tips to run strong!

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A digestive system shutdown

When you’re running, oxygen-rich blood is directed away from the stomach and other nonessential organs and sent to your lungs, heart, and other working muscles that need it more during high-intensity efforts. Because your stomach doesn’t have the normal resources to digest nutrients as efficiently as usual, this might be why you end up tossing your cookies, especially if you consume too much fuel while running or too soon after you finish.

Running while it’s hot and humid outside also produces the same result because blood flow is redirected to the skin as a means to cool down the body. To avoid it, practice fueling during training runs to dial in on how much fuel your stomach can handle on race day, says Carwyn Sharp, Ph.D., a Colorado Springs-based exercise physiologist and sports nutritionist. And if you’re consuming energy gels or other sugary foods, try to ingest them with water to aid in digestion. Even when you’re not working out, simple sugar is hard to break down, so downing too much sports drink or gels all at once could spell trouble.

Dehydration also slows the digestion process even more, so sipping water early and often is important to help you digest food better. “Hydration is key to maintaining a healthy GI and avoiding nausea after workouts, but it’s a balancing act to hydrate enough to avoid nausea but not too much so as to cause it,” says Sharp.

[8 Expert Tips on How to Avoid Pooping During a Race]

Increased pressure on the stomach

“When you run at a high intensity, you increase the pressure in the intra-abdominal space, which puts pressure on your stomach,” Sharp says. This occurs because you use your core more and take heavier breaths while you’re running. When this happens, it can force contents in your stomach back up into your esophagus—possibly all the way back up to where it started.

This scenario is more likely if you had a large quantity of food or liquid in your stomach before a run. This amount is highly individualized, however, so determining what your body can tolerate is essential, especially going into a race.

“The more food you have in your stomach during an intense race or workout, the higher your risk of vomiting,” Sharp says.

Some runners might face a disorder like acid reflux called gastroesophageal reflux disease (GERD) and are at an increased risk of experiencing this scenario. That’s because their lower esophageal sphincter—the muscles between the esophagus and the stomach—are weakened and may relax when they are not supposed to.

GERD can be treated with medications or an adjustment in diet away from foods that can irritate the esophageal lining, such as acidic foods, tomato products, fatty foods, alcohol, and coffee, Sharp says.

Consuming the wrong foods and beverages beforehand

Steer clear of highly acidic foods like citrus fruits (oranges, berries, grapefruits), processed cheeses, as well as liquids like soda or orange juice before your run.

“Acidic foods and beverages cause the stomach environment to be more acidic,” Sharp says, “which slows emptying of the stomach contents into the small intestine, but also increases risk of vomiting.

High-fat, high-protein, or high-fiber meals and snacks are a no-no before a workout as well because they slow down the gastric emptying process. In other words, the food stays in your stomach longer, and it might still be present during your run and give you that “brick in the belly feeling” that’s hard to keep down.

[Should I Eat Before or After a Workout? Here’s How to Fuel Every Distance]

To keep food-induced vomiting at bay, try not to eat during the two-hour window before a hard workout or race. “If you do need to eat something, make it bland and small in volume,” Sharp says.

If diet adjustments don’t work, take antacids or Pepto-Bismol about an hour before running to reduce nausea and vomiting.

Stopping too quickly

Hitting the brakes hard after your last interval or once you’ve crossed the finish line can wreak havoc on your stomach because it’s not prepared for the rapid change in exertion, causing you to feel ill as you return to normal. (It’s similar to how you might feel after riding a wild roller coaster.) This can be exacerbated if you really push hard during the final stretch, Sharp says.

Rather than dropping to the curb, try to keep walking or jogging to give your body time to readjust and ward off stomach cramping. Also, resist chugging a sports drink or downing food too quickly. Sip on water, keep walking, and allow your body to return to stasis level.

[Variations on the Cooldown]

Excessive dehydration

According to William Roberts, M.D., you might be getting nauseated if you’re an especially heavy sweater. If you lose more than 4 percent of your body weight while running, some studies say your gut quits absorbing liquids correctly, which causes queasiness.

“This is especially true for those who are dehydrated before they start to replace fluids during exercise,” he says.

For those who believe spilling your guts is a sign of a race well run, it’s not. Vomiting can cause damage to the lining of your esophagus, which can affect digestion.

[How to Carry Water on a Run or During a Race]


This story was originally published in 2016.

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Morning sickness – nausea and vomiting during pregnancy

Nausea and vomiting can be common during pregnancy. Most people call it ‘morning sickness’. 

But feeling sick or vomiting can happen at any time of the day or night. Some women find it lasts all day.

Nausea and vomiting happens because of hormonal changes in your body. It can be particularly common during the first 3 months.

It can be unpleasant and exhausting. But it doesn’t mean that there is anything wrong with your pregnancy. It usually clears up by 16 to 20 weeks.

There is no cure for morning sickness. But there are things you can do to help with the symptoms.

If your morning sickness causes you problems, talk to your GP, midwife or obstetrician. They might recommend some safe medications that may ease symptoms. You may have to go to hospital if your sickness is severe.

Severe morning sickness (hyperemesis gravidarum)

Hyperemesis gravidarum is a more severe form of morning sickness.

About 2 out of every 100 women will get severe morning sickness. 98 out of 100 women will not.

You’re more likely to have severe morning sickness if you:

  • have a family history of bad morning sickness
  • had severe morning sickness during a previous pregnancy
  • are expecting twins, triplets or more
  • suffer from migraines
  • get bad motion sickness
  • used to get sick if you took contraception containing oestrogen
  • are having a molar pregnancy – this is when some of the cells that form the placenta or afterbirth grow abnormally (this is rare)

There are support groups for women who have severe morning sickness. You can find a support group near you on the Hyperemesis Ireland website.

Hyperemesis gravidarum

Symptoms of morning sickness

Symptoms of morning sickness include:

  • nausea – the feeling that you need to be sick
  • being sick (vomiting)
  • losing weight
  • dehydration – if your sickness is severe


If you are losing fluids through vomiting you may become dehydrated. This can happen with morning sickness and severe morning sickness.

Signs of dehydration include:

  • having dark pee or peeing less often than normal
  • dryness in your mouth and lips
  • feeling faint, dizzy or unwell
  • your heart beating faster than usual

Staying hydrated

It’s important to stay hydrated when you are feeling unwell.

Aim to drink 200ml of fluid  every hour for 10 hours. 200ml is about one glass.

Take small sips continuously rather than drinking it all at once. Drinking large amounts in one go can make you feel sick.

Your taste may change when you are pregnant. Try drinks you may not normally have.

If you are finding it hard to drink liquids try:

  • drinking through a straw
  • adding ice cubes to drinks
  • sucking ice cubes or ice lollies
  • flavoured drinks like watered-down fruit juice, fizzy drinks (or flat fizzy drinks), milk, flavoured milk, sports drinks or fruit cordials
  • eat foods with a high water content such as fruit, yogurt, jelly, soup, custard, ice-lollies

How to cope with morning sickness


Get plenty of rest – being tired can make you feel worse.

If you have children at home, try to go to bed when they do.

Give yourself time to get out of bed if you feel sick in the mornings. Sit up slowly and wait a few minutes before standing. Moving very quickly can make you feel sick or dizzy.

Loud noises and bright lights can trigger sickness in some women. 

Eat small amounts often

It can be hard to eat a healthy diet when you are not feeling well.  Don’t worry if your diet isn’t the healthiest when you are sick.

Aim to eat little and often throughout the day. Eat enough to keep your energy levels up and prevent weight loss.

Things you can do

  • Nibble your favourite foods every 2 hours – long gaps without food will make nausea worse.
  • Dry and plain foods are easiest to tolerate, such as dry toast, biscuits, crackers, pasta, rice, dry cereal and cereal bars.
  • Bring some dry crackers to bed with you to eat when you wake. Wait about 15-20 minutes before slowly getting up after eating the crackers.
  • Keep your meals simple.
  • Have easy-to-prepare foods in the house, such as beans or ready made meals.
  • Eat foods that have lots of energy in a small amount, such as nuts, cheese, hummus, full-fat yogurt, avocado.
  • Eat more when you are hungry – do not wait for mealtimes.

Avoid food smells

Some cooking smells may make you feel sick. Having easily- prepared or ready-to eat foods in the house is useful so that you can avoid cooking.

When food is being cooked you could go out for a short walk, or sit in a different room with a window open.

To block out smells, try putting a scented handkerchief to your nose. Use a scent that you find soothing, like essential oil or fresh cut lemons.

Try ginger

Eating foods or drinks that contain ginger may help to reduce mild nausea and vomiting. Check with your pharmacist before taking a ginger supplement to make sure it’s safe for your pregnancy. 

Take folic acid

Take folic acid at the time of the day you are feeling best.

Some women choose to take a multivitamin throughout their pregnancy. This can be difficult to take for some women while they are not feeling well.

Some brands have a liquid form of antenatal multivitamins. Sometimes this can be easier to take.

Folic acid when planning a pregnancy

Rinse your teeth after being sick

If you vomit, rinse your mouth out with water. Your teeth will be softened by your stomach acid, so do not brush straight away. Wait about an hour to brush your teeth.

Oral hygiene can be difficult when you have severe morning sickness. But it’s important to look after your teeth and gums.

Nighttime Nausea Is a Thing, and Here’s What Could Be Causing It / Fitness

When we think of nausea, especially in the mornings, it is often associated with an early sign of pregnancy, although it can also be linked to a number of other health problems, from motion sickness or anxiety to an adverse effect to medication. Or, it could be morning sickness, just at night …

The term is incredibly deceiving because despite what many people think, morning sickness during pregnancy doesn’t just happen in the mornings. According to Today’s Parent, the symptoms (which can happen as early as 3 weeks into pregnancy, but usually disappear by weeks 12 to 16) can happen later in the day, or even in the night, because of blood sugar. “Some women get sick later in the day if they haven’t maintained a balanced blood sugar level,” midwife Nicola Strydom told the publication.

This can happen if a woman has eaten sugar or carbohydrates, which could cause a spike in blood pressure, and then a crash. But eating too late at night could also cause problems. An expectant mom shared her struggles with What To Expect, explaining that her “morning sickness” is worse at night and she found that eating something small for dinner, or earlier in the night, helped reduced the effects at bedtime.

Nausea occurs more frequently on an empty stomach, so it is important to eat small meals throughout the day to keep the glycemic index balanced and avoid that awful feeling right before bed. Healthline also offers some tips on treatment and prevention, noting that women should avoid triggers (like smells) that make them nauseous, consider adding ginger into their diet and eat dry, bland foods like crackers or toast, as soon as they wake up.

Acid reflux could also be contributing to night sickness, and FirstCry Parenting notes that it’s important to sleep in the right position. Pregnant women should use pillows to prop their heads up, and “sleep on your left side with your right knee bent,” the publication writes.

Final thoughts on the topic: Although no one ever tells you morning sickness isn’t reserved only for mornings, this is a very real and normal side effect of pregnancy. However, it’s hard to self diagnose, and if these symptoms persist, it is always recommended to see your primary care physician who can offer a more accurate evaluation.

[Image via Shutterstock]

What Morning Sickness Really Feels Like

You know what they never taught us about in sex ed? Morning sickness. And as someone who wants to have kids one day, I would like some answers.

Sure, I sort of know what it is (there’s puking involved, yes?), but why does morning sickness happen? Does random nausea mean you might be pregnant? Is there any way to prevent morning sickness (🙏)? These are the questions that keep me up at night.

And whether you’re currently pregnant or think you might want to be eventually, I’m gonna go ahead and bet you have some of the same Qs. Don’t worry, I’m here to help help. But as a person with no medical degree who’s never experienced morning sickness herself, here’s where I call in backup (aka, four ob-gyns).

First, let’s define morning sickness. “Many women, I can’t say all women, but many women get nauseous during pregnancy,” explains Mary Jane Minkin, MD, clinical professor in the Department of Obstetrics, Gynecology, and Reproductive Sciences at the Yale University School of Medicine. “It’s called morning sickness because many people experience nausea and vomiting in the morning, however, there are many women who experience these symptoms throughout the day,” adds Heather Irobunda, MD, an ob-gyn based in Queens, New York.

Ok, now that we’ve got the basics down (morning sickness = nausea and vomiting during pregnancy and it doesn’t just happen in the morning) let’s get down to the nitty gritty of why it happens, what it feels like, and what you can do about it.

Below, find literally everything you could ever want to know about morning sickness.

What causes morning sickness?

Short answer: Experts don’t totally know. “No one really knows the exact mechanism of nausea, but we do think that it’s partly because of the hormonal changes—mostly beta human chorionic gonadotropin (hCG), which is the baby hormone that’s produced in very high amounts,” says Sherry A. Ross, MD, women’s health expert and author of She-ology and She-ology, the She-quel: Let’s Continue the Conversation. Doctors think higher levels of hormone are responsible for morning sickness because women who have higher levels of hCG, like those who are pregnant with twins, tend to experience more nausea.

It could also have to do with the increased production of the hormone progesterone, says Dr. Irobunda. “The extra progesterone may cause your gastrointestinal (GI) tract to slow down, causing food to sit in your stomach longer than normal which can give you a nauseous feeling,” she says.

As for why morning sickness usually happens in the morning, experts think it’s because some women’s symptoms worsen when they have an empty stomach, Dr. Irobunda says. That’s why some docs recommend patients with morning sickness eat something small before getting out of bed, adds Dr. Ross.

What does morning sickness feel like?

Welp, it kinda sucks. It ranges from a mild queasy feeling to the more extreme kind of nausea that you feel when you have the stomach bug, says Dr. Minkin. If you’re in the unlucky group, it can be “10 to 12 weeks of feeling exhausted and miserable from being on the verge of throwing up 24/7,” says Dr. Ross. Ugh.

Either way, you’ll probably be more sensitive to smells that have never bothered you before. According to Dr. Ross, everything from the smell of coffee brewing in the morning to your partner’s body wash can send you running to the toilet. Yikes.

Is morning sickness a good sign?

It definitely can be! Dr. Ross tells her patients that morning sickness is a great first sign of pregnancy. “When people have nausea I’m always like ‘ah, I’m so happy for you’ because it’s a good sign that things are going in the right direction,” she says. In other words, it means your body is producing the hormones it should be.

But don’t freak if you don’t have it. If you’re not nauseous, it doesn’t necessarily mean that anything is wrong, says Dr. Minkin. It just means you’re lucky.

Early Result Pregnancy Test, 3 Pack

First Response

And if you have random nausea, it doesn’t automatically mean you’re pregnant. If you think you might be, pick up a First Response home pregnancy test kit, says Dr. Minkin. She recommends this one because it’s most accurate and can pick up on tiny levels of hCG before you even miss your period.

When is morning sickness the worst?

Good news: Morning sickness doesn’t last through the entire nine months of pregnancy (phew). In fact, it tends to be the worst during the first eight weeks, says Dr. Ross. It should stop by the end of the first trimester, so around 13 weeks.

But, FWIW, some women do experience morning sickness all the way until 20 weeks, or halfway through the pregnancy, says Dr. Minkin. And in some super rare cases, it can last throughout the whole pregnancy, says Jackie Walters, MD, an Atlanta-based ob-gyn and author of The Queen V: Everything You Need to Know About Sex, Intimacy and Down There Care. In that case, you’ll definitely want to talk to your gyno about ways to manage it. Speaking of which…

Is there anything you can do about morning sickness?

Yup. Thankfully there are a ton of ways to relieve morning sickness. From eating strategies to natural remedies to prescriptions, here’s what the experts recommend.

Eat bland foods

Saltine Crackers


Stick to the BRAT diet (that’s bananas, rice, applesauce, and toast), suggests Dr. Ross. These foods and other blah, easy-to-digest foods like crackers and clear soups are less likely to upset your stomach and trigger morning sickness symptoms.

Have small, frequent meals

As I mentioned earlier, morning sickness can be worst when you have an empty stomach. By eating small, frequent meals, you’ll always have a little something in your stomach so the whole empty stomach thing never comes into play. Plus, it’s easier on the digestive system, says Dr. Irobunda.

Eat and drink separately

If you find that sipping on a bev while you’re eating makes you feel queasy, try eating and drinking separately, says Dr. Irobunda. Doctors aren’t totally sure why it works, but it seems to help.

Stick with foods that sound good to you

Craving chocolate cake? Eat it for three meals a day if you want. It’s way more important to focus on getting enough calories in vs. nutrition during this time says Dr. Minkin. Your prenatal vitamin will ensure that the baby is getting the right nutrients, so just focus on eating meals that sound good to you.

Keep a food journal

It helps to learn what foods and smells agree with you—and which ones definitely don’t. Keep a notebook in your kitchen or purse and jot down what makes you feel like you’re gonna hurl so that you can avoid those things accordingly, suggests Dr. Ross.

Try ginger

Ginger is thought to help by relaxing the GI muscles associated with morning sickness, explains Dr. Ross. You can drink it in a tea, pop a ginger capsule, suck on a ginger lozenge, sip a non-alcoholic ginger beer, the world is your oyster.

Take some vitamin B6

Taking 25 milligrams of vitamin B6 three times a day is a game-changer for some women, says Dr. Ross. This is another case where gynos aren’t really sure why it works, they just see clear results. If taking it orally doesn’t help, you can also ask your ob-gyn about getting a dose of vitamin B6 through an IV once or twice a week, says Dr. Minkin. She’s had patients swear by it.

Consider taking a prescription

If you’ve tried all of the remedies above and you’re still puking your guts out, talk to your doctor. There are prescription medications, like the mega popular Diclegis—which is a combination of vitamin B6 and an antihistamine—that can help you feel better, says Dr. Minkin.

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90,000 Why do you feel nauseous during training and how to deal with it

Nausea during training is probably familiar to all novice athletes. As a rule, it appears when the strength is already at the limit, and can torment not only beginners, but also advanced athletes.

I still get sick from time to time in CrossFit training when I give my best. This forces you to slow down or stop altogether so that you do not have to use the bucket of magnesia for other purposes.

Below we will break down the two main causes of nausea and tell you how to deal with it.

Increasing acidity

When exercise intensity is increased strongly and the glycolytic and phosphagenic pathways are used for energy production, hydrogen ions build up in the muscles and blood, which changes the pH of the blood to an acidic side.

This condition is called acidosis. It negatively affects muscle contraction, causes nausea, and makes you stop so that your body can restore its pH balance.

How to deal with

  • Reduce intensity. The body will cope with hydrogen ions, and the nausea will go away.
  • Train regularly. Lactate helps to eliminate hydrogen ions, so increasing the amount of lactate in the blood decreases the risk of acidosis.
  • Drink an alkalizing drink. It will help to cope with the growing acidity.

You can use sports drinks or make your own:

  • 1 liter of water;
  • juice of one lime or lemon;
  • ¼ teaspoon of Himalayan or Celtic salt (regular salt will work as well).

Alkalizing sports drink can help prevent nausea, prolong working time before muscle fatigue and protect the body from dehydration. A 2016 study of found that an alkalizing drink helped reduce blood viscosity during exercise by 6% compared to 3% of regular water intake.

Slow down digestion

During intense exercise, blood rushes to the working muscles to provide them with sufficient oxygen, and to the skin to cool the body.At the same time, the blood supply to the internal organs, including the digestive organs, decreases.

A 2011 study showed that when VO2max (maximum oxygen consumption) is reached, the blood supply to the abdominal organs, kidneys and non-working muscles is reduced by 80%. The results of experiment in 1987 proved that blood flow in the superior mesenteric artery, which supplies blood to the digestive organs, decreases by 43% after just 15 minutes of exercise.

In addition, intense physical activity slows down gastric emptying – the removal of food from the stomach into the duodenum.As digestion slows down, eating heavy-to-digest foods shortly before exercise can cause nausea.


  • Eat at least two hours before training. So the stomach has time to digest food. Choose foods that are high in protein and carbohydrates, as foods high in fat take longer to digest.
  • Drink sports drinks. According to study , sports drink with 7% carbohydrates significantly accelerates gastric emptying during physical activity.


During intense and prolonged exercise, the body loses a lot of fluid with sweat. Drinking plain water can lead to hyponatremia, a condition in which the concentration of sodium ions in the blood falls below normal.

According to study , hyponatremia can cause nausea and vomiting during intense exercise.

How to Cope

carbohydrate-electrolyte drinks will help replenish sodium reserves.According to study , the most effective way to rehydrate is by consuming fluids with 8.6% carbohydrates, a combination of glucose and fructose.

If you have your own ways to cope with nausea during exercise, share in the comments to the article.

90,000 media found a link between Navalny’s poisoning and Bykov’s hospitalization – RBK

The Insider and Bellingcat suggest that an unknown poisonous substance was applied to Bykov’s clothes. However, he did not put it on right away, and after Novosibirsk on April 14 and 15 he held several events in Yekaterinburg, during which he felt normal.

According to investigators, Bykov put on the poisoned clothes on the morning of April 16. He and his wife arrived at the airport to fly to Ufa, and only at check-in began to feel nauseous. On the plane, the writer began to vomit, sweating increased, he lay down on the floor (the publications especially note the similarity of the symptoms and behavior of Bykov and Navalny). After landing in Ufa, his speech was impaired.

Read on RBK Pro

The editor-in-chief of Novaya Gazeta, where Bykov works, Dmitry Muratov, told the authors of the material that a private plane with resuscitators on board was hired to transport the writer from the Ufa hospital to Moscow.“Already when the Yak-40 took off from Moscow and it was an hour away from Ufa,“ the Ministry of Health received a command to turn the plane to Moscow. ” The pilot contacted the hospital and said that in ten minutes he would be obliged to obey and turn around. Then Muratov called the man who, in his words, “occupies one of the highest positions,” after which the pilot said that he was allowed to continue the flight, ”writes The Insider.

Bykov told The Insider and Bellingcat that he had no clue about the motives of the likely poisoners.

Writer Dmitry Bykov was hospitalized in Ufa

Bykov’s hospitalization in Ufa became known on April 17, 2019.Initially, it was reported that the writer was suspected of having a stroke, but this diagnosis was not confirmed. Doctors put him into an artificial coma. The chief resuscitator and anesthesiologist of the Ministry of Health, Igor Molchanov, then assessed Bykov’s condition as serious.

On April 19 he was transferred to one of the Moscow clinics. Two days later, the writer came to his senses and began to talk. On April 29, Bykov was discharged, he reported that he was feeling well and would resume his lectures after the May holidays.

While still in the hospital, the writer stated that the reason for his hospitalization was poisoning.He could not tell what exactly he was poisoned with, but rejected versions of hypertension, diabetes, gastronomic or alcoholic excesses.

“I have read the investigation, and I have no reason not to trust it,” Bykov told the BBC.

A representative of Dmitry Bykov told RBC that he was not ready to comment on the investigation.

RBC sent a request to the FSB DSP.

In 2020, Navalny fell into a coma during a flight from Tomsk to Moscow; after several days of treatment in Omsk, he was transported to Berlin, where he regained consciousness two weeks later.Doctors from the Charite Clinic stated that he was poisoned with a substance from the group of cholinesterase inhibitors. The German government reported that traces of poison from the Novichok group were found in Navalny’s body and that their findings were confirmed by independent laboratories from France and Sweden. Omsk doctors did not find traces of the oppositionist’s poisoning. The Kremlin has denied involvement in the poisoning of Navalny.

CNN, Bellingcat, The Insider and Spiegel in a joint investigation linked the poisoning of the oppositionist with the activities of the FSB.On December 14, an investigation by The Insider, Bellingcat and CNN came out, the authors of which concluded that a group of FSB officers were following Navalny. During a large press conference on December 17, Putin called the publication “the legalization of materials from the American special services.” The FSB’s Public Relations Center called the investigation “a planned provocation aimed at discrediting the FSB and its employees.”

90,000 What is agoraphobia and how people live with it

Alena Agadzhikova has agoraphobia: she is afraid to leave her apartment and end up in an unfamiliar place.Alena decided to conduct an experiment by placing herself in uncomfortable conditions. PR manager Dasha Tikhomirova agreed to do the same. Both girls kept diaries in the here and now format. Afisha publishes them together with a commentary from a psychotherapist.

What is agoraphobia and where does it come from?

Dmitry Komarov

Psychotherapist of the Moscow clinic Mental Health Center

Agoraphobia is suggested to be fear of open spaces.In fact, this is both the fear of being unable to leave a place or situation immediately, and the fear of being away from home. The discrepancies are associated with the fact that at the time this term was introduced into psychiatry, there were no triggers of agoraphobia typical of the modern world: public transport, passenger planes and shopping centers. Perhaps in the days of Karl Westphal (a German psychiatrist and neuropathologist who lived in the 19th century, the author of many psychiatric terms. – Approx. Ed. ), who first described agoraphobia, the open spaces of the market squares were as unpleasant as our metro in rush hour.Agoraphobia is now commonly referred to as fear and avoidance of independent movement outside the home (or other safe place).

The disorder arises from a predisposition to anxiety and psychological factors. The latter, according to the British Ministry of Health, include: sexual abuse (especially in childhood), loss of a loved one, divorce, job loss, anorexia or bulimia, alcohol abuse, being in an unhappy relationship or in a relationship with an overcontrolling partner.National studies from various Western countries show figures ranging from 1.3 to 3.5% of the prevalence of agoraphobia in the population. Anxiety disorders refer to diseases in the development of which a factor of genetic predisposition plays a relatively large role, therefore their incidence is approximately the same in different countries of the world. Based on this, it can be assumed that in Russia, about one out of 50 people also suffers from agoraphobia.

Most people with agoraphobia start with panic attacks in public.

For many, a panic attack turns out to be one of the worst emotional experiences of their entire lives.

The strongest fear is instantly associated in the brain with the place where this event occurred. When you visit it again, the deep parts of the brain responsible for the fear reaction (in particular, the amygdala) are activated again and further strengthen this conditioned reflex connection.In the future, fear can spread to other places that are similar to the first in some way: for example, it becomes scary to be not only in that supermarket on the minus ground floor where the first panic attack occurred, but also in all public places where you need to go down to escalator. If a person knows what kind of sensations await him in such places, he begins to avoid them. It turns out that he actually avoids not public places, but his own emotional reactions and difficult bodily sensations that arise there .Sometimes a person can have both claustrophobia and agoraphobia. There are no contradictions here: a common place in these states is the fear that it is impossible to get out of the situation instantly and find yourself in a “safe” place. Both the crowd on the street and the closed doors of the elevator can hinder this.

What if someone with agoraphobia confronts their fear?

Dasha Tikhomirova, 30 years old

PR manager.Has been suffering from agoraphobia since the age of 9. For the last three years it has been in a state of exacerbation. As part of the project, it is decided to go down to the metro.


Plan: take the metro for two stops. I definitely can’t do it anymore. One is not interesting, because I want to live the moment when the train stops, the doors open, and I will not run out and go on. The last time I was on the subway was about a year and a half ago , when I was trying to get out of my comfort zone and train myself. Before that, I had not been on the subway for about two years.Agoraphobia started in me during an exacerbation of anxiety-depressive disorder, which I have been suffering from for several years. In general, panic attacks have been with me all my life: they came and went, I felt bad on the subway or on the street, but I coped without medication, because I had no choice – I hid these states from my family and friends, I was ashamed. Now I have been seeing a psychiatrist for three years now, visiting a cognitive-behavioral psychotherapist once a week, drinking a “cocktail” of antidepressants and tranquilizers.

© From the diary of Dasha Tikhomirova


Usually, I start to feel anxious about going outside as soon as I know about the need for this action. This can be the decision to go to a cafe with a friend, the need to go to the doctor unaccompanied by her husband, or anything else. Anxiety intensifies on the eve of the event. This manifests itself in hyperventilation (frequent shallow breathing.- Approx. ed. ), stomach cramps, dizziness, pain in all muscles of the body, tachycardia. It happened this time too.

When Alena invited me to participate in the experiment, I was overwhelmed by horror. I immediately began to choke, my forearm muscles tightened.

Further in the head, as a rule, one and the same thought goes in cycles, from which it is almost impossible to get rid of. Now this is a picture of how I cannot get out of a subway car during a panic attack.Such situations have happened to me more than once, and at once they merge into one terrible scene. A panic attack is approaching, I restrain it by all methods I know of: touching objects, listening to smells, counting colors, kneading my feet. Fear drives me crazy and depressive. It is at such moments that the desire to commit suicide is exacerbated to the maximum.

© From the diary of Dasha Tikhomirova


In order to trick my brain, I have developed a system of rituals that helps to reduce anxiety to a level that allows you to even step over the threshold at home.Here they are: wash your hair, style your hair beautifully, choose your clothes carefully. Then I start putting on my makeup. These are my ways to put extra armor on my body to protect myself from the outside world. In addition, it is a rather meditative process that requires concentration. There is less room for anxiety in consciousness. At the same time, I think over all the options for the development of events and persuade myself that none will lead to my death.

So, I carefully put on my makeup, dressed up, admired my new coat and pink boots, checked whether clonazepam (an antiepileptic drug, used as prescribed by a doctor) was in place.- Approx. ed. ) and whether it is enough (I usually carry at least three pills, although a quarter or a half is enough to relieve a panic attack). I said all the options: I’m starting an attack, I’m shaking, I can’t breathe, I grab onto all the surrounding objects, everyone is staring at me, it’s dark in my eyes, my legs are bent, I dream of losing consciousness, nothing helps, the train gets stuck in the tunnel, I’m getting even worse, clonazepam does not help. I run to the doors of the carriage to run out as soon as they begin to open, my legs give way, I lie and sob.I contrast: “You know that one does not die from a panic attack!” People around are not angry: they either sympathize or will not pay attention. Someone might offer help. It gets a little better.

© From the diary of Dasha Tikhomirova

Topic details

What are panic attacks and how to get rid of them

What are panic attacks and how to get rid of them


I could not make up my mind to accomplish this little feat alone, I asked my husband to take part in the experiment.My husband gets dressed, I am furious, because it seems to me that he does it too slowly. When the inevitable is near, you want it to happen as soon as possible. We go out into the street, my husband is trying to distract me with conversations on side topics. When he sees that it doesn’t work, he starts asking questions so that I can express my feelings. Speaks out all the ways of salvation: we can go home at any time, we will be very close to home, so it won’t take much time. If it gets bad, you will bury yourself in me.We continue to walk: I am surprised how the road to the metro has changed (new paths, fences), the area in front of the metro (we have set up a mini-square with benches!), The entrance lobby (kind of fashionable).

© From the diary of Dasha Tikhomirova

Going down. I feel the muscles in my legs tighten, and it hurts to walk. I turn off consciousness, something like depersonalization sets in. As if from the sidelines, I observe how the girl Dasha applies a ticket, stands on the platform.The train is coming. Once I enter it, it will be impossible to escape. I start to cry (this is another stress relief mechanism recently discovered by accident). In front of the carriage doors, I say: “NO!” I take my husband’s arm, I feel that I will collapse now.

All muscles are so tight that it is almost impossible to walk. It is impossible to breathe. Hands and feet are icy, palms clammy with sweat are shaking.

People look sideways, we get out quickly.I feel like I’m sweating right through to my beautiful blue coat. The scarf is pulled down, the feeling of something on the throat is unbearable. I’m very hot, we walk back down the street. It’s freezing outside, but I can’t button up.

© From the diary of Dasha Tikhomirova


Walking is still very painful, you have to walk slowly. Gradually, the panic disappears, and a feeling of devastation remains.I begin to freeze, wrap myself in a scarf, overcome the rest of the path in silence, sadness becomes kind of flat, I hate and despise myself. I try to feel sorry for myself, but I can’t. I feel ashamed in front of my husband.

Entering home, I immediately take off all my clothes, wash off my makeup, and climb under the covers. Relaxing is not easy, I put clonazepam under my tongue. I feel nauseous, the muscles gradually relax, but they continue to ache. My head hurts. Even the drawn curtains let in too much light. I wrap myself in a blanket very tightly, put on a mask over my eyes and fall into a long, disturbing sleep.Waking up, I continue to feel nausea, headache, dizziness, anxiety returns, but drinking clonazepam again means falling asleep again. I try to disperse, eat something, breathe. I turn on the series “Colombo”: I know all the episodes by heart, but watching something new in this state does not come out. “Columbo”, “Poirot” and “Harry Potter” are stored on the computer in the “Eternal” folder – I turn them on randomly in any incomprehensible situation.

© From the diary of Dasha Tikhomirova

For the next two days I continue to experience headache and muscle pain, it is difficult for me to concentrate, I feel morally exhausted, frenzied.I cancel all the few things I do, eat, take care of myself, lie under the covers, correspond with the psychiatrist, note that this time I went much further than before (for example, often I just cancel the meeting, unable to cope with the anxiety), I praise myself for that I learned to stop on time and generally decided to try. I believe that everything will be fine.


Actually, my life is not that terrible. I learned to build it, bypassing trigger situations. I hardly go to public places, but I can go to a concert or a restaurant if my husband is with me or not far away.I communicate with friends by inviting them to visit or visiting them. I go to the doctors by taxi. Previously, this was difficult for me, but now I almost do not feel unbearable anxiety. I see progress in treatment and thank myself for every small step in overcoming myself and the disease.

© From the diary of Dasha Tikhomirova

Topic details

“I will say – they will immediately be fired”: what is it like to hide a mental disorder from colleagues

“I will say – they will immediately be fired”: what is it like to hide a mental disorder from colleagues

Alena Agadzhikova, 25 years old

Has been agoraphobic since the age of 13.At the age of 20, there was an aggravation with thoughts of suicide. For five years he has been taking antidepressants and undergoing psychotherapy. The last year has been in a state of incomplete remission. As part of the project, he flies from Moscow to Prague.

13:00. Flight from Moscow to Prague

It’s so gray outside the window that you don’t want to live. I’m taking a taxi to Sheremetyevo. I’m terrified: I’m late for my flight, and even the alarm goes off scale. I thought that after two flights in my life, in which I was naturally delighted with air pockets and felt as safe as possible, there would be no more fear.But he is.

“What if the plane leaves and I stay at the airport? I will have a panic attack, I will lie on the ground, everything will darken in my eyes, as it was once in the subway. We’ll have to call an ambulance. I don’t care what people think! Do not give a damn about the fact that my body becomes icy from the inside at such moments, and I can hardly speak. ” Great thoughts! Most of it before departure.

I see terminals in the distance. So maybe I won’t be late. When I have such anxiety, my intestines weaken.Perhaps this is the most socially troubling thing for me. To lie in the middle of the crowd wherever it went, but to do it … We drive up. I’m not late. Glory to Gagarin.

© From the diary of Alena Agadzhikova

I am sitting in the airport lounge. I was not late, although I could. It seems that I need to listen to my mother more, even if she gets on my nerves with her catastrophization. Airplanes are behind the glass. The state, despite yesterday’s gin, is quite tolerable.Probably, it is worth saying thank you to phenazepam (a drug, taken only as directed by a doctor. – Approx. Ed. ) and to myself. Two years ago, the mere thought that I would be flying in an airplane plunged me into a state of acute panic. Imagine that I am sitting, drinking water here without gas, and even one … Show me such a photo of me before, I would definitely say that this is photoshop. And the evil one: “I feel so bad that I can’t fly anywhere, and you are kidding!”


It all started at the age of 10.Then I started having panic attacks. Nobody knew what was happening to me: they took me to church, to a fortune-teller grandma, once they took me to the district psychiatrist – he refused to take “without taking into account”, asked for a bribe and wrote out “Novo-Passit” (a sedative of plant origin – Approx. Ed. ). As a child, I did not know what was happening to me: it was just that one night I suddenly started shaking, and it also seemed that my head was going numb. Further – as in a fog: unbearable horror and fear.Fear of death? No, I was not afraid to die, I knew that I was not dying. Fear of losing control? More like the truth.

Fear of fear, fear of this uncontrollable shaking, numb hands, growing terror? Yes.

I recently had five sessions of cognitive behavioral therapy. The psychiatrist said that panic disorder develops into agoraphobia most often in those alarmists who do not have a specific phobia.In other words, fear of death, fear of social judgment, fear of stroke are things that are less likely to cause you to be afraid to be far from home. But the feeling of impossibility to experience this difficult condition, concentration on it is exactly that.

© From the diary of Alena Agadzhikova

Panic disorder was followed by OCD (obsessive-compulsive disorder in which a person has obsessive thoughts, memories, movements and actions, as well as a variety of fears.- Approx. ed. ). For OCD – anxiety-depressive disorder (a disease in which a person experiences both anxiety and depression without a clear dominance of one of the conditions. – Approx. Ed. ). It is now I, examined by psychiatrists and undergoing psychotherapy, I know what is wrong with me. And then, ten years ago, information came in pieces and via the Internet.

My life underwent serious changes when I suddenly began to be terribly afraid to be away from home.I remember at the age of 14 I stayed with my boyfriend on the other side of Moscow. It was night, neither he nor I had money. He fell asleep, I did not. And suddenly a familiar horror began to seize me, the back of my head began to grow numb. It was cold outside the window, the lanterns were burning with a nasty yellow light. I felt incredibly sad and scared. I thought, “What should I do if I want to go home right now? How can I get home RIGHT NOW, because the metro does not work, there are no buses, my parents will not understand me if I call and in a panic ask to pick me up.WHAT SHOULD I DO?” Panicked thoughts began to come one after another. I was shaking. I was afraid to wake the guy, because he, like me, did not know what was happening to me, so I would twist my finger at my temple.

I lay and could not move, thinking of all kinds of crazy ways to get out of the house.

So I simulate a pain in my stomach and call an ambulance, but no, the ambulance will take me not home, but to the hospital … So I borrow money from friends, but from whom? Everybody sleeps.And how can you explain what the urgency is? Morning has come. I never slept. All day I walked in a fog, periodically plunging into panic attacks and gritting my teeth.

© From the diary of Alena Agadzhikova


Over time, these attacks became more frequent. It became hard for me to go out of town. Already on the bus, I began to think: “What if I want to get off the bus right now? I can’t do it.And if I do, where should I go? ” The image of me in an unfamiliar area, unable to move, is firmly entrenched in my head. I began to avoid traveling anywhere. The metro was the next nightmare. A train stopping in a tunnel is the worst picture that has remained with me so far.

The quintessence of a situation that cannot be influenced. I was lucky to get both claustrophobia (fear of confined space) and agoraphobia. Every time a train gets stuck in a tunnel, I sit for three or four minutes, and then I start rushing about.I imagine how I break the glass, how I go out. It becomes hard to breathe, it feels like my own horror will eventually drive me crazy. My dream, when a train stops in a tunnel, is to faint and wake up when he is already at the station. But, unfortunately, I have fainted only a few times in other circumstances.

© From the diary of Alena Agadzhikova

At the age of 20 I started treatment – antidepressants, therapy.If it had started earlier, at least four years, much could have been avoided. The same agoraphobia would be easier to overcome. My social capital would be even greater, the amount of accumulated impressions too. But right now, it’s a sin to complain.

Planting begins.

I try to take a deep breath and realize what work has been done over the years.

15:25. I’m on a plane

We took off. I smile and fall asleep. This is my third flight in my life and my first flight in the evening.It’s so great that the light is off in the cabin and you can see the glow of the blue horizon of the clouds – like Kuindzhi in the picture. It feels like all the problems remained below, under the clouds, and lulls me in a warm cradle. What, as it seemed to me for many years, can drive me crazy, gives a feeling of happiness and peace. I feel light and relaxed. I can’t continue writing, I was struck by a strong nap. I’ll sleep.

© From the diary of Alena Agadzhikova

Did not sleep.We fly over Vilnius. I would like to visit Vilnius. And in general, everywhere, since now I can fly.

How did it happen that I started flying? My loved one moved to Prague. My best friend has been living there for the eighth year. And so I won a grant covering flights, accommodation and study for a month in Prague. In fact, I had no inner choice: either now or never.

Topic details

“Touching buttons is a real torture for me”: how people with phobias live

“Touching buttons is a real torture for me”: how people with phobias live

First flight

On the eve of the first flight, I was thrashed in the morning.Parents saw off. Most of all I was afraid of waiting. The flight itself is not very good, I am not afraid of heights and death. I will die and die. Now, in general, it seems to me that death by falling is far from the worst option. Beautiful, and in the chest everything skips at the end. But then I was shaking because I was afraid of panic at the moment of waiting, fear of fear. The tranquilizer and awareness of what was happening helped me. Here I go through the registration. Here is passport control. Here I am laying out my things at customs. But – wow – I’m in the green hallway. It made me laugh that technically this is a “nowhere” zone.I prepared myself for the worst: “Land the plane, call the orderlies” . But – as is almost always the case – my catastrophization has overdone it. Yes, I was shocked, yes, I felt anxious. But all this is at the level of tolerance. I think it was largely because my loved ones met me in another country.

© From the diary of Alena Agadzhikova

My worst recurring dream looks like this.I find myself in a foreign country where everyone speaks an incomprehensible language. I do not know where to go, and when I try to ask passers-by, only a wheezing sound comes from my mouth. The people around me keep away from me, and I sit on the ground and cry as waves of terror roll over me over and over again.

In a dream, I want to go home. The house is my apartment. My bed.

I remember a real incident from childhood that resembles this dream.One day my mother took me to the market and walked quickly forward. I stared at the bright counters and lost sight of her. I started looking around, my head was spinning, I wanted to call my mother, but for some reason I felt scared and ashamed to open my mouth. An unforgettable feeling in the worst sense of the word: a five-year-old child lost in the market whirlwind. When my mother saw me in the crowd, she pulled me by the sleeve of her jacket and scolded me loudly, harshly. That was how she expressed fear.

© From the diary of Alena Agadzhikova


We sat down. I like it when people clap the pilot, even though many people think it’s ridiculous, they say, thanks for being alive. And I am glad of this fact. Even in the cockpit it is very beautiful and the control of the plane seems to me to be some kind of impossible action. Pilots are cooler than gods – so why not give them a pat?

End of the journey. Return flight

It has been three weeks since I last opened this text. During this time, a lot has happened. Outside the window – minus 54 degrees.I am flying to Moscow. During takeoff, it seemed to me that something bad would happen. This is my fourth flight. In the past, I was very proud that I like air pockets and rolling. This time I was nearly dropped in a panic by the fact that we failed in the second minute of takeoff. I felt dizzy, sweat appeared on my forehead, then the plane somehow spun and spun, and the magnificent clouds outside the window did not calm one drop. In one second, I imagined that I was losing control of myself: that I was starting to cry, I was hysterical, or I was silent like a fish.I’m not afraid that others will see it. This very state is terrible: cold, I am locked in my own body and can hardly speak. And people are even more frightening with their worried faces.

© From the diary of Alena Agadzhikova

Do you know how I spent the last ten days? “And” is irony. Lying at a friend’s house because I broke my leg. What I was most afraid of happened, without traveling until I was 25 – I was seriously injured in a foreign country.If my beloved man and best friend had not been in Prague, I don’t know what state my psyche would be in, even though I’m drinking an antidepressant. On the seventh day, I had a panic attack. Nightmares began to dream: here I can not fly away from the country, here I lie and do not speak, before my eyes – terrible pictures, some figures with gouged out eyes. I am plunged into my own panic, I am not distracted by anything, I seem to myself insane and losing control. And again this feeling of being trapped in the body. This is probably where agoraphobia and claustrophobia are similar: a deep-seated feeling of impossibility to do anything.Moreover, the impossibility is not real, but internal, phobic.

Adrian (Alena’s beloved person, to whom she flew to Prague. – Approx. Ed. ) sits next to him on the plane and draws. Outside the window – the bright sun and curly clouds. In the morning, my mother sent photos of frozen trees of South Butovo and signed: “Beauty!”

All I dream of is walking into my clean home in the middle of an icy land, throwing my crutches, crawling under the covers and watching Homeland until I feel comfortable and at home again.

Is this progress? Definitely. Can you travel if you have agoraphobia? Of course. Whether you are 20, 30, 40 or 50 years old. It won’t be easy, but the very fact that there will be will help move away from the feeling of uncontrollable inevitability.

© From the diary of Alena Agadzhikova

Can agoraphobia be overcome?

Dmitry Komarov

Psychotherapist of the Moscow clinic Mental Health Center

Agoraphobia can take on a progressive nature, over time taking away more and more freedom from a person, squeezing his comfort zone to the limits of the apartment.This can happen when a person unquestioningly obeys orders dictated by fear. Unfortunately, the disabling effect is often exerted by the appointments of doctors in medical state institutions. The average neuropsychiatrist in a polyclinic or PND is likely to prescribe phenazepam for anxiety disorder, the reception of which situationally suppresses panic attacks, but in the long term is addictive and becomes another form of avoidance.

Since agoraphobia is almost always a consequence and avoidance of panic attacks, treatment should be directed towards coping with panic disorder.The first line of therapy, according to international recommendations (American Psychiatric Association and British National Health Service), should be one of the following methods: cognitive-behavioral therapy or a course of taking an antidepressant of the SSRI group (selective serotonin reuptake inhibitors. – Approx. Ed. ) … Considering that cognitive-behavioral therapy provides a more stable effect and requires only short-term work (8–12 sessions), we in the clinic recommend this option to most clients.

I’ll tell you a little about the content of psychotherapy. Cognitive theory considers panic attack primarily as a consequence of an incorrect assessment of bodily symptoms: “If my heart rate is over 130, then there is something wrong with my heart”; “My head is spinning, so I can lose consciousness”, “The world around me looks strange – I’m probably going crazy,” etc. At the first stage of work, we identify these erroneous interpretations and replace them with more rational ones, teaching the client the basics of normal physiology.This allows you to neutralize a significant part of the experience.

After a while, we urge client to purposefully generate fear and relive it in the safe environment of therapy session . This is the key to the treatment. A person who decides on exposure (deliberate immersion in fear) forever changes his attitude towards panic attacks. He learns new knowledge: that unpleasant bodily symptoms are not a threat, that there is no need to fight a panic attack, there is no need to escape from it, because it passes by itself.And after that we work with agoraphobia itself. After going through the first exposures, the client already understands that the panic attack is actually not as bad as it seemed before; at this stage, he is already ready to conduct sessions outside the office, in frightening public places – first, accompanied by a therapist, then on his own.

To me agoraphobia is metaphorically represented as some kind of evil entity, using threats and cunning, trying to linger in the host’s body for as long as possible, like a parasite.

Since lies and manipulation are her main weapons, she is unlikely to be able to outplay her with the help of any tricks: she reads your intentions three steps ahead. Only one remedy is effective: persistent systematic disobedience to her demands. You can make this task easier for yourself: find, for example, through some forum on anxiety disorders, a person in your city with a similar problem and train in self-exposure together.You can arrange challenges to each other with visits to various public places. Mutual face-to-face support from someone who knows firsthand about your difficulties is a powerful medicine.

The loved one of a person with agoraphobia needs to find a certain balance: on the one hand, give him a sufficient amount of emotional care, on the other, try to indulge his avoidance less. The gradual, jointly planned abandonment of ubiquitous escort and the transition to independent movement outside the home is an essential component of psychotherapy.

Topic details

Don’t Go Crazy: How Treatment Partners Help People With Bipolar Disorder

Don’t Go Crazy: How Treatment Partners Help People With Bipolar Disorder

How to recognize myocardial infarction

Date added: 06 April 2015

Clinical manifestations

Myocardial infarction can be both the first manifestation of coronary heart disease and occur against the background of long-term angina pectoris.The main symptom of myocardial infarction is an attack of unusually intense pain behind the breastbone, which in patients with angina pectoris does not go away after taking the usual doses of nitroglycerin. The pain is usually wavy in nature, it can often spread to the left arm, shoulder blade, neck, teeth. Myocardial infarction occurs both against the background of high blood pressure, and can be accompanied by a decrease with a sharp deterioration in general condition (severe weakness, cold sweat, nausea). One of the characteristic signs of a heart attack is the fear of death.

The manifestations of a heart attack may differ from the classic picture. There are so-called atypical forms. The abdominal form is manifested by severe abdominal pain, nausea, vomiting, and indigestion. The asthmatic form can proceed as an attack of bronchial asthma (shortness of breath, difficulty breathing, feeling short of breath). One of the most insidious forms of myocardial infarction is painless, which occurs without the typical painful attack (angina pectoris). The only manifestation of this form may be an unexplained deterioration in general condition, decreased exercise tolerance, and weakness.

First aid

1. Call an ambulance (preferably a specialized cardiology or resuscitation team). It is advisable to meet an ambulance with someone from relatives or neighbors in order to reduce the time before the provision of qualified medical care.

2. Reducing the load on the heart – lie down, take sedatives.

3. Reception of nitroglycerin under the tongue before relief of a pain attack.

4. Aspirin 325 mg – chew.

5. Try to relieve pain (analgin, non-steroidal anti-inflammatory drugs).

If you suspect cardiac arrest (lack of consciousness, breathing, pulse on the carotid arteries, blood pressure), you should immediately start resuscitation measures:
Precardiac blow (short strong blow with a fist to the sternum). May be effective in the first seconds of ventricular fibrillation. If ineffective, it is necessary to immediately begin chest compressions and ventilation by mouth-to-mouth or mouth-to-nose method.These activities should be continued until the arrival of the ambulance.

Zofran instructions for use: indications, contraindications, side effects – description Zofran syrup 4 mg / 5 ml: vial. 50 ml per set with measured. spoon (2766)


After oral administration, ondansetron is completely absorbed from the gastrointestinal tract and undergoes the “first pass” effect through the liver. C max is reached approximately 1.5 hours after administration. Bioavailability increases slightly with simultaneous ingestion of food, but does not change with antacids.

After rectal administration, ondansetron is determined in plasma after 15-60 minutes. The concentration of the active substance increases linearly, C max is reached approximately 6 hours after administration and is 20-30 ng / ml. The decrease in plasma concentration occurs at a slower rate than after ingestion of the drug (due to continued absorption). Absolute bioavailability is 60% and does not depend on gender.


The distribution of ondansetron is the same when taken orally, intramuscularly and intravenously; V d upon reaching an equilibrium state – about 140 liters.Plasma protein binding – 70-76%.

Pharmacokinetic parameters of ondansetron do not change after repeated oral administration, parenteral or rectal administration.


Ondansetron is eliminated from the systemic circulation mainly as a result of metabolism in the liver with the participation of several enzyme systems.

When used in doses exceeding 8 mg, the blood content of ondansetron increases disproportionately, because when taken in high doses by mouth, it is possible to reduce its metabolism during the “first pass” through the liver.

The absence of the CYP2D6 enzyme (derisoquine polymorphism) does not affect the pharmacokinetics of ondansetron.


Less than 5% of the administered dose is excreted unchanged in the urine. T 1/2 after oral, intramuscular and intravenous administration is approximately 3 hours

T 1/2 after rectal administration – 6 hours

Pharmacokinetics in special clinical cases

Distribution ondansetron depends on the gender of the patients.So, in women, when taking the drug inside, there is a high rate and degree of absorption of ondansetron, as well as a decrease in systemic clearance and V d .

In patients with CC 15-60 ml / min, both systemic clearance and V d of ondansetron are reduced, resulting in a small and clinically insignificant increase in T 1/2 (up to 5.4 h). The pharmacokinetics of ondansetron practically does not change in patients with severe renal impairment on hemodialysis.

In patients with severe liver dysfunction, the systemic clearance of ondansetron sharply decreases, as a result of which its T 1/2 (up to 15-32 hours) increases, and oral bioavailability reaches 100% due to a decrease in first-pass metabolism.

Studies in healthy elderly volunteers have shown an insignificant, clinically insignificant, age-dependent increase in bioavailability and T 1/2 , which can reach 5 hours.

When studying the effect of ondansetron in children, it turned out that after a single IV administration the drug at a dose of 2 mg (children aged 3-7 years) or 4 mg (children 8-12 years old), the absolute values ​​of clearance and V and were reduced, while the magnitude of the change depended on age.So, in children aged 12 years, the clearance was 300 ml / min, and in children aged 3 years – 100 ml / min, V d – 75 liters and 17 liters, respectively. Dose adjustment based on the patient’s body weight (0.1 mg / kg, up to a maximum of 4 mg) compensates for these changes and normalizes the systemic exposure of ondansetron in children.

The experience of using Zofran in elderly patients and in patients with renal insufficiency is limited by intravenous and oral routes of administration, however, it can be assumed that when using the drug in the form of suppositories T 1/2 in such patients will not differ from T 1/2 in healthy volunteers, since the rate of elimination of ondansetron when administered with suppositories does not depend on systemic clearance.

8 signs of a heart attack that everyone needs to know about

During a heart attack, a person experiences a sharp attack of pain, grabs his heart and falls without moving? This only happens in the movies – everything is different in life.

Myocardial infarction is damage to heart cells. For their work, oxygen is needed, which is supplied with the blood stream. If blood flow in one of the heart vessels is disrupted, the cells stop receiving the necessary nutrients and die. Tissue damage occurs gradually, so the symptoms increase from subtle discomfort in the chest to severe pain.
This means that timing is the most important thing in heart attack therapy. If you recognize the manifestations of an attack in time and call an ambulance, you can save your life. Let’s talk about the main symptoms that people complain about during a heart attack:

1. Severe chest pain
Pain in the region of the heart is the most characteristic symptom of a heart attack. But everyone perceives it differently: there may be an unpleasant tingling or burning sensation in the region of the heart, a feeling of tightness in the chest, or simply unpleasant heaviness.You should be alerted to any chest discomfort that does not go away after a few minutes or gradually increases.

2. Pain spreads to the left side of the body
Most often the pain goes to the left shoulder or arm, sometimes it radiates to the shoulder blade or chin. But if chest discomfort is accompanied by pain in another area of ​​the body, such as the back or upper abdomen, this is also an alarming sign. Because of this, the first manifestations of a heart attack are sometimes confused with an ache with flu or poisoning.In any case, an intense pain that has arisen sharply is a reason to call an ambulance.

3. It becomes hard to breathe
Respiratory disorders, especially those that have arisen for the first time, are a frequent companion of myocardial infarction. When the heart pump is unable to deliver blood to cells and tissues, they begin to experience oxygen deprivation. The brain makes the lungs work harder and breathe in more oxygen. Therefore, if someone from your loved ones suddenly starts breathing heavily or complains of a feeling of lack of air, call a doctor.

4. It seems that you are about to faint
Dizziness and lightheadedness are characteristic manifestations of a heart attack. If the heart stops working effectively as a pump – that is, delivering blood to every cell in our body and maintaining a normal level of blood pressure – the brain is the first to feel it. Lack of oxygen leads to malnutrition of brain tissue and light-headedness.

5. You start to sweat a lot
Sometimes cold sweat breaks through during a heart attack – unlike episodes of excitement, the attack does not stop after a couple of minutes.Therefore, if you woke up at night from the fact that you sweated a lot and after a few minutes the sweating does not stop, it’s time to call an ambulance.

6. Nausea or vomiting appears
Of course, such signs can speak of anything at all: about poisoning, an attack of heartburn or inflammation of any organ of the digestive system. However, if the nausea occurs for no reason and is accompanied by pain in the upper abdomen or chest, it is probably due to a disturbance in the activity of the heart.This manifestation of a heart attack is more common in women, so you should be especially careful about it.

7. Unmotivated weakness arises
If suddenly you suddenly feel a weakness that prevents you from continuing to work or doing something habitual, this is an alarming signal that should not be attributed to a hard working day. Of course, severe weakness can develop with other diseases, for example, with severe anemia, poisoning or stroke, but in any case, you will need the help of a doctor.

8. An attack of arrhythmia develops
Everyone describes heart rhythm disturbances in different ways: sometimes a sinking of the heart is felt, sometimes extraordinary contractions slip through. In any case, if the uneven heart rate persists for several minutes, this is unlikely to be due to an extra cup of coffee or fatigue.

According to a study published in the Journal of the American Heart Association, young women tend to ignore the alarming manifestations of a heart attack and often fail to recognize its early stages.But this situation is not one to worry about “false alarms.” It is better to play it safe and save the life of yourself or your loved ones by calling an ambulance.
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